title: Clowning as a supportive measure in paediatrics - a survey of clowns, parents and nursing staff.
abstract: BACKGROUND
  Hospital clowns, also known as clown doctors, can help paediatric patients with the stress of a hospitalization and to circumvent the accompanying feelings of fear, helplessness and sadness, thus supporting the healing process. The objectives of the present study were to clarify the structural and procedural conditions of paediatric clowning in Germany and to document the evaluations of hospital clowns, parents and hospital staff.
  
  
  METHODS
  A nationwide online survey of hospital clowns currently active in paediatric departments and an accompanying field evaluation in Hamburg hospitals with surveys of parents and hospital staff were conducted. In addition to items developed specifically for the study regarding general conditions, procedures, assessments of effects and attitudes, the Work Satisfaction Scale was used. The sample included n = 87 hospital clowns, 37 parents and 43 hospital staff members.
  
  
  RESULTS
  The online survey showed that the hospital clowns are well-trained, motivated and generally satisfied with their work. By their own estimate, they primarily boost morale and promote imagination in the patients. However, hospital clowns also desire better interdisciplinary collaboration and financial security as well as more recognition of their work. The Hamburg field study confirmed the positive results of the clown survey. According to the data, a clown intervention boosts morale and reduces stress in the patients. Moreover, there are practically no side effects. Both parents and hospital staff stated that the patients as well as they themselves benefited from the intervention.
  
  
  CONCLUSIONS
  The results match those of previous studies and give a very positive picture of hospital clowning, so that its routine use and expansion thereof can be recommended. Furthermore, the intervention should be subject to the rules of evidence-based medicine like other medical treatments.
authors.affiliation: Forschungsgruppe Epidemiologie und Evaluation, Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik (W29), Universitätsklinikum Hamburg-Eppendorf Martinistraße 52, Hamburg, D-20246, Germany. barkmann@uke.de.
authors.forename: Claus
authors.initials: C
authors.lastname: Barkmann
authors.forename: Anna-Katharina
authors.initials: AK
authors.lastname: Siem
authors.forename: Nino
authors.initials: N
authors.lastname: Wessolowski
authors.forename: Michael
authors.initials: M
authors.lastname: Schulte-Markwort
mesh_terms: D000328:Adult; D003625:Data Collection; D005260:Female; D005858:Germany; D006760:Hospitalization; D006801:Humans; D027641:Laughter Therapy / Q000379:methods*; D008297:Male; D009013:Morale; D009740:Nursing Staff / Q000523:psychology*; D010290:Parents / Q000523:psychology*; D010372:Pediatrics / Q000379:methods*; D015397:Program Evaluation